Monday, March 30, 2015

Doha Review : Carpal Tunnel Surgery at Al Ahli Hospital Doha

We all dread surgeries, and we only want to do it at absolute necessity. Which brings me to the second surgery of my life-my carpal tunnel syndrome surgery on my right hand

As you know, I went back to Malaysia and spent 6 months of my pregnancy there, which left me feeling very resentful and bitter. Little did I know then that the time I spent in pastry school and with the MIL would come back to haunt me in Doha

As you can see, the husband and I had decided it would be good for me to take up baking classes to take up my time in KL. Otherwise I would be sitting idle and not doing anything productive. So then here I was 5 days a week going to my classes, whisking, whirring, washing and spending almost 8 hours a day on my feet. And to top it off, when I go back to my husband's I still have to cook dinner for 3. Over time I got fed up with the latter and started coming back home late to avoid making dinner and changed my dinner to milk, bread, cereal and fruits. Sigh, what a nightmare my pregnancy was. Let's not backtrack further into this fuckery and lets move on to my CTS

My CTS developed over a period of years. If I remember correctly it was showing signs in 2010 when I was still staying in a rental and working at Hewlett Packard in Cyberjaya. One fine evening I woke up from my evening nap feeling numbness on my middle finger (my CTS happened on my right hand) I shook it off, thinking I must have slept wrongly. Over time, the pain gradually increased albeit slowly. Mind you I still thought it was some ligament issue, I met a doctor in a private hospital and he couldn't tell if it was CTS. I couldn't break the knuckle on my middle finger

Then last year I got pregnant. I was pain free for 8 months! And after delivery the first pain I experienced was my ankle pain, I guess it started because I was overweight by 20kgs. As the water in my body was getting used up and I was losing weight the ankle pain dissipated to a minor nag-but a nag still. It was there when I walked for long, stand for long or bend my ankle for long periods of time. After 2 months, the CTS exaggerated to a a jolt of electricity running down my arm every time I move my arm from the most mundane of work (taking off my clothes) to heavy work (cooking, doing the dishes) The CTS came to a point where I could no longer ignore it, the frequency of which I was getting the 'jolts'on my arm were getting more more

I spoke about my arm and ankle to my gynecologist and she told me to get it looked at with the ortho in Aster, but I didn't want to travel all the way to Al Hilal so I decided to get a hospital nearer to where I stayed

So I rang Al Ahli hospital and scheduled for an appointment with an orthopedic. I requested for the best and they gave me Dr Emmanuel Tolessa. My first appointment with him was pretty good, he had a quick look on my ankle and hand and told me there and then I could possibly have CTS because the symptoms he was looking for were present. Al Ahli being Al Ahli, they didn't have a neurologist so Dr Tolessa requested me to go to Al Emadi and get a Nerve Conduction Test dont over there with a Dr Muhammad. I called Al Emadi a million times and these are the responses I got from them:

no one picked up my calls

someone did pick up my call but cut my call

someone cut my call mid conversation

finally when I did manage to get thru, they asked me to come in the morning at 7 am to get a number and come back after 4pm to meet the doctor (and they will not take me in according to the number I was given int he morning, but on a first serve basis)

WHAT FUCKERY!!!

At my next gynecologist appointment I asked Dr Sabitha if they had a neurologist in Aster and she said they have. So I booked an appointment online with Dr Harsha Bhatia, and boy was she good! She scheduled me for a nerve conduction test on a weekend, during break hours where the whole clinic was empty save for her and a few nurses. I got undivided attention and she was very kind to explain everything to me, and she did two kinds of nerve test, one using the old 'ring'method and the newer method where they just put a round disposable plaster hookable to the machine. After the test was done, she printed it out for me and explained to me which reading meant what and highlighted the important pages. It was confirmed. I had CTS. On a scale of 1 to 10 it was at a 3. Which wasn't so bad in numbers but if that's the pain I am feeling I can't imagine how a 9 or full 10 would feel. Her advice was to lose weight and see how it goes from there.

I waited for a month. Still no progress at getting better. So I went back to Al Ahli with my report and met Dr Tolessa again. I told him to schedule me for a surgery. His surgery days are Mondays and Thursdays. I asked for a Thursday. I gave myself a whole month for the surgery so I could look for a maid. I was asked to schedule another appointment, this one with the anesthetist so she could explain to me the options I had for this 'day'surgery as known as in-and-out surgery

The anesthetist I got explained that I had two options

Local anesthesia where only my right arm is numbed, and I am to breastfeed right away. The arm will be elevated and two tourniquet will be tied on the right hand, one will be slowly loosen up if I felt pain, and I will pain which she explained to me. The way she said was that the pain would be painful in a unbearable sort of way

I would be given a general anesthesia which would pretty much put me to sleep until the surgery is over. I would miss out on what will be happening in the OR (Operating Theater) and I wouldn't be able to breastfeed right away. I will have to wait for 6 hours before I can.

I signed my consent form, and opted for the local anesthesia.

Came my surgery day, I was at Al Ahli at 7.30 am, having fasted from midnight the day before. Luckily this time they had my paperwork done so I was given my room at about 8 am. This time it was on the 3rd floor of the hospital where they house day surgeries

A nurse came in to take my weight, height and insert a canula on my left hand. Dr Tolessa came in to draw dots on my palm, indicating where the incision would be made. I would be having 6 stitches. In case you're wondering why I didn't go with he keyhole/endoscopic surgery, and why Dr Tolessa suggested me to have this surgery, he said the healing time would be the same and it made no difference with the key hole or normal surgery. His words, not mine

I was whisked in the OR, and I could see that I was patient number 2 for Doc Tolessa, he had about 5-6 patients on that day. The white board was pretty much filled up with surgery schedules. Then an anesthetist came and said she will explain to me the anesthesia options aftr 5 miuntes. She promptly went on to yak on her phone and I was rolling my eyes when Dr Tolessa walked in and asked to bring me in and then she came to me and asked why I signed for local anesthesia. I told her I want to be able to breastfeed. She was also telling me off for drinking water early in the morning after I had been admitted. I told her I was too thirsty, and it was only 3 gulps. She was like 3 cups? I couldn't even begin to describe the fuckery she was.

When I was finally wheeled into the OR, I asked Dr Tolessa if I could watch the surgery, he said no but I could watch the reflection on the lights above me (without my glasses I'm as blind as a bat) so no point really if I wasn't going to be allowed to watch my own surgery then might as well I go to sleep. The idiotic anesthetist kept harassing me to agree to general anesthesia because she said I will be able to breastfeed right away anyway and another doctor chimed in saying its painful why don't you take the general anesthesia. By now I was getting angry and didn't want to scream at them so I asked them one final time if it was Ok to breastfed with the GA and she said yes so I agreed and the next thing I know I was given a mask and within 5 seconds I went into a dreamless stateless empty black shit sleep

When I woke up my head was groggy but it cleared up pretty fast. I was in a room with curtains separating me from other patients. I could her a lady next to me moaning she wanted to be given something because she was in pain. My right hand felt better, no more jolts of electricity! Hurrah! When I was finally wheeled out the waiting area, my poor lone husband and son were surrounded by the white and black ninjas. I lamented to the nurse it's like fish market in here and she was like yes, its only a minor surgery for one person but the whole family is here.

I had a huge badass white bandage on my right hand. Overall the surgery probably took about 45 minutes but the time wasted waiting to go in the OR and all added up to another 30 minutes. After I had fed my hungry son, an Indian ortho came in and briefed about the hand care and the next appointment which was in 3 days. The bandage would be removed and I would be given a water proof plaster to cover the wound.

I showed up for my appointment, as usual 30 minutes early but Dr Tolessa is a busy bee, never free to entertain a patient more than 10 minutes. I was put in an operating room, and a male nurse came in, opened the bandage, cleaned my wound and wrapped it with a clean plaster and covered it with water proof plaster (the glue didn't stick so I bought a new one from the pharmacy) The nurse provided me with extra Waycare plasters and iodine swabsticks to clean and dress my wound. He asked me to clean every other day but me being me I cleaned it regularly every DAY after I showered and just before BED TIME. First with povidone-iodine swab and then a sterile water proof plaster. I kept my hand dry (was asked to until the stitches were removed) by wearing gloves in the shower, when I changed my son's diaper, etc etc etc

1. Then came the day when I had to remove the stitches. This is what I did-in ORDER

2. went to registration and the guy behind the counter said Dr Tolessa is on leave on that day. I said I have a walk-in with him to remove my stitches

3. guy calls the ortho clinic but no one picks up

4. i went to ortho clinic and asked for Dr Tolessa or someone who can remove my stitches. Some nurse starts off with they only have one doctor today and already there's been 10-11 patients for him on that day. I said mine is just a cut and go thing, squeeze me in somewhere, it's a 10 minute procedure

5. an Indian nurse gave me a number and off I went to the registration again

6. I was issued a number and some papers (insurance paid everything) which I brought to the ortho clinic

After 15 minutes of waiting I decided it was enough so I knocked the clinic's door and asked how much longer it was going to take. Another 15 minutes, a nurse answered. The doctor had a patient, he gave someone an injection and then went off for prayers and then after that he was going to see another patient before seeing me

I was called in after 15 minutes to the operating room. Sat on the bed and waited for the doctor. A nurse came in and cleaned the wound with iodine. She went out (to ask if the doctor was going to remove the stitches or she has to do it) The doctor gave his permission for her to do it because after that she came and in and told me the doctor will see me after the stitches has been removed.

She cut the first stitch with a smallest sickle blade I have ever seen in my life. The thong she was using to hold the sticthes pulled my skin and I owh-ed in pain so she took a pair of sterile scissors and used that to told the stitch knots so she could cut the stitching underneath and pull it away.

After she was done, she went out to get the doctor and he came in. After a round of greetings he said the wound looks ok, I should keep it covered with normal plaster for 3 days before losing the plaster completely. I should also mention to you that I had been using an EXTRA strong water proof adhesive I bought from the pharmacy near my house and BOY was it STRONG. After 8 and half days of using it, on the 9th day it peeled some part of my skin together. I told the doctor this and he prescribed me a MEMO cream (insurance didn't cover it so I had to cough up 65 riyals) Some fat Arabic doctor that goes by Dr Nasser

Off I went to the hospital pharmacy and got my cream. When I reached home, I went to my local pharmacy and got a better plaster for my wound. I cleaned the wound regularly with povidone-iodine swabs I had bought earlier

My surgery cost 8000 riyals and my insurance paid for it. I only paid 10 riyals for some admin fee of somesort fuckery

I had my surgery on the 12th March 2015

I had my bandage/dressing removed on the 16th March 2015

I was on water proof plaster until 25th March 2015 when my stitches were removed

I kept my hand relatively dry on 26th March 2015 (used gloves)

27th March 2015 the plaster was coming off and I was loosely following the doctor's advise to keep it dry for 3 days after the sticthes were opened